Influence of Surgeon Experience on the Accuracy of Implant Placement via a Partially Computer-Guided Surgical Protocol

Purpose: There is always a tension between allowing novice trainees to place implants independently and the need to achieve accurate functional and esthetic outcomes. The aim of this study was to measure the influence of surgeon experience on the accuracy of implant placement using a teeth-supported surgical guide via a partially guided surgical protocol. Materials and Methods: Twenty partially edentulous patients were randomly allocated to expert and novice surgeon groups. Implant drilling and placement for the two groups were performed through a flapless surgical technique using surgical guides following a partially guided surgical protocol. The study primary independent variable was the surgeon experience, while the outcome variable was the accuracy, which was measured based on the differences in implant angulations preoperatively and postoperatively. Two-way analysis of variance (ANOVA) was applied to find the influence of surgeon experience, implant size, and the interactive effect of surgeon experience and implant size on the angular deviation. Results: A total of 40 implants were inserted in 7 men and 13 women. There was no significant difference (P = .453) in the mesiodistal deviation between the expert and novice groups. In a buccolingual direction, the expert group performed more accurate implant placement (3.7 ± 3.35) compared with the novice surgeons (8.5 ± 6.3). Conclusion: The level of surgeon experience affects the accuracy of implant placement using a teeth-supported surgical guide; therefore, the use of computer-guided surgery via a partially guided protocol does not completely compensate for the level of operator experience. However, such surgical guide might be used in a whole task training of novice surgeons, as it can bridge the gap between simulation training in vitro and freehand surgery in a clinical setting. Keywords: computer-guided surgery, implant placement, surgeon experience, surgical guide